Dr. Tom, Author at City Integrative Rehabilitation

What’s the difference between radial shockwave (EPAT) and focused shockwave (ESWT)?

1 Comment / Shockwave, Treatment / Dr. Tom

The choice between focused shockwave therapy (ESWT) and radial shockwave therapy (EPAT) will depend on the specific condition being treated and the overall treatment plan. Both treatments are non-invasive and use high-energy sound waves to stimulate healing in the musculoskeletal system, but they differ in the way the sound waves are delivered.

What’s the difference between radial shockwave (EPAT) and focused shockwave (ESWT)? Read More »

Physical therapy space containing a treatment table and Normatec recovery sleeves.

What is Normatec Compression Therapy?

Treatment / Dr. Tom

Normatec compression therapy is a popular treatment option for individuals who are looking to improve their recovery time and reduce muscle soreness after intense physical activity. The therapy involves the use of specialized compression sleeves that are worn on the legs, arms, or hips. These sleeves are connected to a machine that inflates and deflates

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House Calls for Severe Back Pain

Treatment / Dr. Tom

Back pain is a common and often debilitating condition that can interfere with daily activities and quality of life. For those experiencing severe back pain, the thought of leaving the comfort of their own home to seek medical treatment can be overwhelming. This is where the option of a house call can be incredibly beneficial.

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What is Shockwave Therapy and How Can It Help You?

Treatment / Dr. Tom

Shockwave therapy, also known as extracorporeal shockwave therapy (ESWT), is a non-invasive treatment option for individuals suffering from musculoskeletal disorders such as tendonitis, plantar fasciitis, and tennis elbow.

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Common Questions About Shockwave Therapy

Is Shockwave Therapy the Same as Ultrasound?

No. Therapeutic ultrasound uses continuous, low-intensity sound waves to gently warm tissue and improve circulation. Shockwave therapy (ESWT) delivers high-energy acoustic pressure pulses that penetrate deep into tissue, triggering a cascade of biological repair including new blood vessel formation (neovascularization), stem cell activation, and breakdown of calcifications. The two are fundamentally different in mechanism, intensity, and clinical outcomes.

Is Shockwave Therapy the Same as a TENS Unit?

No. A TENS unit sends low-voltage electrical impulses through the skin to temporarily block pain signals from reaching the brain. It provides short-term symptom relief but does not treat the underlying condition. Shockwave therapy uses acoustic (mechanical) energy, not electrical, to stimulate tissue regeneration and long-term healing at the cellular level.

Does Shockwave Therapy Hurt?

Most patients describe shockwave therapy as intense but tolerable. You may feel a rapid tapping or pulsing sensation over the treatment area. Discomfort varies depending on the condition and sensitivity of the area being treated, but sessions are brief (typically 5 to 10 minutes per area) and no anesthesia is required. Many patients report that any discomfort during the session is well worth the results.

How Many Shockwave Sessions Will I Need?

Most conditions require 3 to 6 sessions, spaced about one week apart. Some patients experience noticeable improvement after the first or second session, while the full biological healing response continues to develop over 8 to 12 weeks following treatment. Your doctor will recommend a specific treatment plan based on your diagnosis and response to therapy.

Treatment Comparison Chart

How does shockwave therapy compare to surgery and injections for common conditions?

Condition	Shockwave Therapy	Surgery	Injections (Cortisone)
Partial Rotator Cuff Tear	8-12 weeks to significant healing. Minimal downtime. No incisions or anesthesia required.	Surgical repair + 4-6 months recovery + extensive rehab. Risks include scar tissue, infection, and stiffness.	Temporary relief lasting weeks to months. Repeated cortisone injections weaken tendons and can contribute to further tearing.
Plantar Fasciitis	3-6 sessions over several weeks. Walk the same day. High long-term success rate.	Plantar fascia release + 6-10 weeks non-weight-bearing. Risk of arch collapse and nerve damage.	Short-term pain relief. Does not address root cause. Risk of fat pad atrophy with repeated use.
Tennis Elbow	3-5 sessions. Return to activity quickly. Stimulates tendon repair at the cellular level.	Surgery + 4-6 months recovery. Reserved for severe cases after 6-12 months of failed conservative treatment.	Temporary pain relief. Studies show worse long-term outcomes compared to no treatment. Weakens tendon structure over time.
Calcific Shoulder Tendinitis	Breaks down calcium deposits non-invasively. 3-6 sessions. Often resolves the condition completely.	Arthroscopic removal + months of rehab. General anesthesia required. Risk of shoulder stiffness.	Cannot dissolve calcifications. Only masks pain temporarily while the deposits remain.
Achilles Tendinopathy	Stimulates collagen remodeling and tissue repair. 4-6 sessions. Continue daily activities during treatment.	Surgical debridement or repair + 3-6 months recovery. Significant risk of re-rupture.	High risk. Cortisone near the Achilles significantly increases rupture risk. Many orthopedists avoid this entirely.

Individual results may vary. Consult with our doctors to determine the best treatment approach for your specific condition.